English: Individuals who develop chronic may have predisposing factors or vulnerabilities which, when combined with overt or covert trigger events (viral illness, psychological stress), result in an initial Illness with associated somatic symptoms including pain and/or fatigue and sleep disturbance. This may lead to the patient engaging in avoidance of activity as a primary coping style, somatization (increased vigilance to physical symptoms) and attribution of the illness primarily toward events outside their control, i.e., external locus of control. Influenced by additional events such as family factors (overprotection, triangulation), social milieu and stressor factors (peer relationship issues), other medical illnesses (low-grade infections, pain/fatigue exacerbations), and psychological events (catastrophizing cognitions), the patient may engage in further withdrawal, leading to deconditioning and snowballing Increasing attributions that their illness/debilitation is due solely to a unitary disease process for which there is a unitary passive treatment (medication, surgery, etc.). The final pathological outcome is a patient who experiences increased social Isolation, increased functional disability, enmeshment with their primary caregivers, and additional biological epiphenomena and high healthcare use that further reinforce a somatic focus and an emphasis on finding a unitary medical “cure.”